gases

Question 1

Sevo MAC

Answer 1

1.8

Question 2

Des VP

Answer 2

669

Question 3

Sevo VP

Answer 3

160

Question 4

Nitrous oxide VP

Answer 4

39,000

Question 5

Iso BGC

Answer 5

1.46

Question 6

Des BGC

Answer 6

0.42

Question 7

No BGC

Answer 7

0.46

Question 8

Sevo BGC

Answer 8

0.69

Question 9

Factors that increase speed of induction

Answer 9

low BGC (low solubility of agents), decreased CO, increasing delievered concentration,

Question 10

VAAs effects on ventilation

Answer 10

depresses ventilation mediated directly through medullary centers and indirectly through intercostal muscle function, RR tends to increase, TV tends to decrease …. drive to breath from hypoxia abolished at 1 MAC

Question 11

VAAs effect on airway resistance

Answer 11

• decrease airway resistance by relaxing bronchial smooth muscle
  NOTE: VAAs are potent vasodilators

Question 12

VAAs effect on hypoxic pulmonary vasoconstriction

Answer 12

reduce effect of HPV

Question 13

VAAs effect on brain

Answer 13

increase CBF and ICP
CMRO2 decreased (except for N2O) and autoregulation is impaired

Question 14

VAAs effect on renal system

Answer 14

decrease RBF, GFR, and UOP

Question 15

How are VAAs metabolized

Answer 15

des and iso metabolized less tha 1%

Sevo metabolized around 5%

Question 16

ISOs effect on CO, HR, BP, SVR, PVR, coronary blood flow

Answer 16

no change
large increase to no change
large decrease to no change
large decrease
no change
increase

Question 17

Sevos effect on CO, HR, BP, SVR, PVR, coronary blood flow

Answer 17

No change
no change
large decrease to no change
large decrease
no change
increase

Question 18

N2O effect on CO, HR, BP, SVR, PVR, coronary blood flow

Answer 18

increase
increase
no change
no change
increase
no change

Question 19

Des effects on HR, BP, CO and SVR

Answer 19

Increase, Decrease, decrease to no change, decrease

Question 20

VAAs mechanism of action

Answer 20

1. stimulate inhibitory receptors
   
   • in the brain… VAAs increase amount of time GABA-A channels are open
2. Inhibit stimulatory receptors
   - in the spinal cord… will produce immobility in ventral horn. site of action= glycine (stimulation), NMDA- glutamate (inhibition) and Na channel (inhibition)

Question 21

Which VAA worsens bronchospam? whats the best choice for bronchospasm risk?

Answer 21

Des, Sevo

Question 22

When should you avoid N2O?

Answer 22

inner ear, intraocular, pneumo… avoid in pregnancy and B12 deficiency

NOTE: does add analgesic properties

Question 23

Why should you not overpressurize Des?

Answer 23

SNS stimulation

Question 24

Des MAC

Answer 24

6.6

Question 25

Iso MAC

Answer 25

1.17

Question 26

NO MAC

Answer 26

104

Question 27

Iso VP

Answer 27

238